I have been having RUQ pain with chronic nausea for 4 months. The pain bores into the back and is very tender over the liver. I had this same pain 5 years ago and it lasted for about 6 months and gradually got better. There is always pressure in the right upper back and it moves into my shoulder and sometimes my arm and neck.

A month ago I woke up in a hot sweat with severe RUQ pain and right chest pain under my right breast. I told the doctor in the ER it felt like someone was ripping something out of my body this time. They had seen that I had had an ERCP in the past 2 weeks and figured it was just that and because it was on right side didn't even look at the possibility it could be my heart. The pain and nausea continue. (The ERCP did not help at all. Only a slight stenosis.)

My rheumie is thinking autoimmune hepatits, however my MRI and ultrasound find nothing wrong with my liver and my liver enzymes are normal. I have low to borderline low platelets and high B12, very low BUN, low protein and low albumin. Very low anion gap to a negative anion gap. Rheumie wants to do a liver biopsy but I am not really wanting to do it because other tests are normal however pain is over the liver area.

The pain is now chronic in my chest, liver area, and back. It is a 6-8 on pain scale, getting worse throughout my 10 hour work day. Ugh!(I am worried it could be my heart, but figured if it was I would already be dead.)

My gallbladder was removed 12 years ago. The ultrasound was normal except for seeing something in one of the bile ducts and dilated hepatic ducts. The "something" was just a stenosis. I got no relief at all from the ERCP. My rheumatologist knows me the best and believes I am not crazy. I get the feeling the gastro docs do think I'm crazy.

Still not sure about the biopsy. I am gonna at least ask for a chest X-ray since both my mother and grandmother passed away of lung cancer. My rheum is convinced it is the liver because of where the pain is and the persistent nausea. Thanks for your interest.

Have you considered Sphincter of Oddi Dysfunction - I have that thought I havent had my gallbladder out. Its the muscular valve at the bottom of the bile and pancreatic duct and it can stop working properly, going into spasm and causing abdominal pain (sometimes severe) and slow bile drainage. If bile is backing up into the pancreatic duct too then that could account for the nausea.
Just a thought anyway - hope you are better now